Cardiac surgery under cardiopulmonary bypass in pregnancy: report of four cases.

BACKGROUND: Open heart surgery during pregnancy is relatively rare at home and abroad, and there is a higher risk and probability of maternal and infant death. How to carry out heart valve replacement under cardiopulmonary bypass (CPB) under the premise of ensuring the safety of mother and child is the focus of attention at home and abroad. CASE INTRODUCTION: We reported four cases of cardiac surgeries under CPB during pregnancy performed in our hospital from March 2020 to March 2021. Two of the patients continued their pregnancy after cardiac surgery under CPB. Three patients had infective endocarditis and the other one had an ascending aortic aneurysm. Three patients underwent heart valve placement with the mechanical mitral valve when the other one underwent Bentall surgery. The operations of four cases were all successful, and further follow-up evaluation of the pregnant women and fetuses showed no abnormalities. The patients' detailed information is shown in the following table. CONCLUSION: Heart disease during pregnancy should be treated actively and proactively when the patient has obvious symptoms. Heart valve replacement under CPB will be the first choice, and this may become the primary surgical treatment for symptomatic heart disease during pregnancy.

Chinese-English Speakers' Perception of Pitch in Their Non-Tonal Language: Reinterpreting English as a Tonal-Like Language.

Changing the F0-contour of English words does not change their lexical meaning. However, it changes the meaning in tonal languages such as Mandarin. Given this important difference and knowing that words in the two languages of a bilingual lexicon interact, the question arises as to how Mandarin-English speakers process pitch in their bilingual lexicon. The few studies that addressed this question showed that Mandarin-English speakers did not perceive pitch in English words as native English speakers did. These studies, however, used English words as stimuli failing to examine nonwords and Mandarin words. Consequently, possible pre-lexical effects and L1 transfer were not ruled out. The present study fills this gap by examining pitch perception in Mandarin and English words and nonwords by Mandarin-English speakers and a group of native English controls. Results showed the tonal experience of Chinese-English speakers modulated their perception of pitch in their non-tonal language at both pre-lexical and lexical levels. In comparison to native English controls, tonal speakers were more sensitive to the acoustic salience of F0-contours in the pre-lexical processing due to top-down feedback. At the lexical level, Mandarin-English speakers organized words in their two languages according to similarity criteria based on both F0 and segmental information, whereas only the segmental information was relevant to the control group. These results in perception together with consistently reported production patterns in previous literature suggest that Mandarin-English speakers process pitch in English as if it was a one-tone language.

[Effect of "Tongyuan" acupuncture treatment on success rate of extubation in stroke patients undergoing tracheotomy].

OBJECTIVE: To observe the impact of "Tongyuan" (regulating the Governor Vessel to tranquilize mental activities, conducting qi back to its origin) acupuncture treatment on cough reflex, pulmonary infection and swallowing function in stroke patients undergoing tracheotomy. METHODS: Seventy-four cerebral stroke patients with tracheo-tomy were randomly allocated to scalp acupuncture and "Tongyuan" acupuncture groups (n=37 in each group). All the patients of the two groups received basic treatment, including treatment of primary diseases, routine nursing, respiratory muscle training, physical therapy, acupuncture of Chize (LU5), Quchi (LI11), Hegu (LI4), Weizhong (BL40), Zusanli (ST36). In addition, for patients of the scalp acupuncture group, the middle 2/5 of Dingnieqianxiexian (MS6), the middle 2/5 of Dingniehouxiexian (MS7) and Dingpangerxian (MS9) on the contralateral side of lesions were punctured with filiform needles. For patients of the "Tongyuan" acupuncture group, Baihui (GV20), Zhongwan (GV12), Guanyuan (CV4), Qihai (CV6), Tianshu (ST25), Feishu (BL13), Pishu (BL20) were needled. The treatment in both groups lasted 30 minutes each time, once daily, 6 times a week for 4 weeks. The cough reflex grading score (CRGS, assessed according to cough, independent expectoration, sputum suction), clinical pulmonary infection score (CPIS, assessed according to the body temperature, white blood cell count, airway secretion in 24 h, PaO2/FiO2, infiltration status, cultured pathogenic bacteria), and swallowing function were evaluated by a researcher who was blinded to the grouping and treatment procedures. The success rate of extubation was calculated in a week at the end of treatments. RESULTS: After the treatment, the CRGS and CPIS of both groups were apparently decreased in comparison with their own pre-treatment (P<0.05), suggesting an improvement of the cough reflex and pulmonary infection. Regarding the swallowing function, of the two 37 cases in the scalp acupuncture and "Tongyuan" acupuncture groups, 9(24.3%) and 19(51.4%) experienced marked improvement, 12(32.5%)and 14(37.8%) were effective, and 16(43.2%) and 4(10.8%)failed in the treatment, with the effective rate being 56.8% and 89.2%, respectively. In regard to the successful extubation, of the two 37 cases in the scalp acupuncture and "Tongyuan" acupuncture groups, 5(13.5%) and 11(29.8%)had a marked improvement, 10(27.0%)and 18(48.6%)were effective, and 22(59.5%)and 8(21.6%)failed, with the effective rate being 40.5% and 78.4%, respectively. The therapeutic effect of "Tongyuan" acupuncture was significantly superior to that of scalp acupuncture in decreasing CRGS and CPIS, and in improving the swallowing function and raising the rate of successful extubation (P<0.05). CONCLUSION: "Tongyuan" acupuncture treatment can improve cough reflex to remove sputum, reduce pulmonary infection, enhance swallowing function, and raise the success rate of extubation in stroke patients, which is better than scalp acupuncture.

High Yield Controlled Synthesis of Nano-Graphene Oxide by Water Electrolytic Oxidation of Glassy Carbon for Metal-Free Catalysis.

The strong quantum confinement effect as well as abundant edges and oxygen functional groups enable nano-graphene oxide (NGO) a variety of intriguing applications such as catalysis, bioimaging, drug delivery and photovoltaic devices. However, the development of NGO is severely hindered because of the difficulty in controlled mass production. Here, we report the efficient synthesis of NGO with a high yield of ∼40 wt % by water electrolytic oxidation of glassy carbon (GC). The NGO shows a high oxidation degree (C/O atomic ratio, ∼1.4) and excellent dispersion stability. Moreover, its size can be easily tuned by the graphitization degree of GC, which enables the controlled synthesis of NGO with average size of 4, 8, and 13 nm and different oxygen functional groups. As metal-free catalysts, the 13 nm sized NGO is found to be beneficial for the oxidative coupling reaction of benzylamine, while the 4 nm sized NGO shows a conversion rate of 88 times higher than 13 nm sized NGO for the oxidation reaction of benzene. In addition, the water electrolytic oxidation mechanism of graphitic materials is systematically studied. It is found that sulfuric acid has a protective effect on the graphite electrode during the water electrolytic oxidation process, and 50 wt % sulfuric acid solution well balances the protection and oxidation processes, leading to the highest oxidation efficiency and production rate.

Synergistic Effect of Aligned Graphene Nanosheets in Graphene Foam for High-Performance Thermally Conductive Composites.

Graphene shows a great potential for high-performance thermally conductive composite applications because of its extremely high thermal conductivity. However, the graphene-based polymer composites reported so far only have a limited thermal conductivity, with the highest thermal conductivity enhancement (TCE) per 1 vol% graphene less than 900%. Here, a continuous network of graphene foam (GF), filled with aligned graphene nanosheets (GNs), is shown to be an ideal filler structure for thermally conductive composite materials. Compared to previous reports, a clear thermal percolation is observed at a low graphene loading fraction. The GNs/GF/natural rubber composite shows the highest TCE of 8100% (6.2 vol% graphene loading) ever reported at room temperature, which gives a record-high TCE per 1 vol% graphene of 1300%. Further analyses reveal a significant synergistic effect between the aligned GNs and 3D interconnected GF, which plays a key role in the formation of a thermal percolation network to remarkably improve the thermal conductivity of the composites. Additionally, the use of this composite for efficient heat dissipation of light-emitting diode (LED) lamps is demonstrated. These findings provide valuable guidance to design high-performance graphene-based thermally conductive materials, and open up the possibility for the use of graphene in high-power electronic devices.

Extraskeletal osteosarcoma in right neck subcutaneous tissue: A case report of an extremely rare tumour.

Extraskeletal osteosarcoma (ESOS) is a rare soft-tissue sarcoma that is treated with surgical resection, chemotherapy and radiotherapy; however, as it is now considered to be radiation resistance, it is associated with conflicting management principles and poor outcomes. A multimodality approach is currently used to treat ESOS, which entails the incorporation of multidrug chemotherapy and/or radiotherapy coupled with surgery to obtain the best outcome; however, there are many factors that influence the treatment effects and clinical outcomes of ESOS. In the present study, a case of an 81-year-old man who suffered from primary ESOS in the subcutaneous tissue of the right-hand side of the neck was reported. The patient was treated several times with partial resection and once with radiotherapy, and was still living following 3 years of follow-up. Thus, the present case report demonstrated that surgical resection and postoperative radiotherapy regimens may be favourable in the short term with a disease-free survival of ~15 months; however, patients are prone to relapse.

Pitch shape modulates the time course of tone vs pitch-accent identification in Mandarin Chinese.

In Mandarin Chinese pitch is used to express both lexical meanings via tones and sentence-level meanings via pitch-accents raising the question of which information is processed first. While research with meaningful sentence materials suggested a general processing advantage of tone over pitch-accents, research on pure tones and nonce speech in pre-attentive processing found that the f0-shape led to timing and site processing differences. The current study reconciles these results by exploring whether the tone advantage found in meaningful speech materials is modulated by the f0-shape by establishing via a gating paradigm the relative timing of tone and pitch-accent identification. Target words containing static (T1) and dynamic (T2, T4) tones were embedded into meaningful sentences and were divided into 50 ms gates which were added incrementally either from the left- or right-edge of the target word. Results showed that dynamic targets had either a tone or pitch-accent advantage contingent on the direction of gate processing. In contrast, for static T1 targets, tone and pitch-accent were identified simultaneously regardless of the direction of gate processing. Altogether, these results indicate that the f0-shape, as defined by pitch dimensions of f0 and pitch range, mediates the timing of tone and pitch-accent identification in meaningful speech supporting highly interactive models of speech perception.

Beneficial effect of farnesoid X receptor activation on metabolism in a diabetic rat model.

Farnesoid X receptor (FXR) is an important regulator of glucose and lipid homeostasis. However, the exact role of FXR in diabetes remains to be fully elucidated. The present study examined the effects of chenodeoxycholic acid (CDCA), an agonist of FXR, on metabolism profile in a rat model of type 2 diabetes mellitus (T2DM). Male Wistar rats (8­week­old; n=40) were randomized into the following four groups (n=10): Untreated control, CDCA­treated, T2DM, and CDCA­treated T2DM. To establish the T2DM model, the rats were fed a high­fat diet (HFD) for 4 weeks and received a single low­dose intraperitoneal injection of streptozotocin (30 mg/kg), followed by an additional 4 weeks of HFD feeding. CDCA was administrated (10 mg/kg/d) intraperitoneally for 10 days. Reverse transcription­quantitative polymerase chain reaction and western blotting assays were performed to determine the RNA and protein expression of FXR, phosphoenolpyruvate carboxykinase, G6Pase, proliferator­activated receptor­Î³ coactivator­1 and short heterodimer partner in rat liver tissue. The results revealed that FXR activation by CDCA did not reduce body weight, but it lowered the plasma levels of fasting glucose, insulin and triglycerides in the T2DM rats. CDCA administration reversed the downregulation of the mRNA and protein expression of FXR in the T2DM rat liver tissue samples. Furthermore, treatment with CDCA reduced the mRNA and protein expression levels of phosphoenolpyruvate carboxykinase, glucose 6­phosphatase and peroxisome proliferator­activated receptor­Î³ coactivator­1 in the liver tissue samples of the T2DM rats. By contrast, CDCA treatment increased the mRNA and protein expression levels of short heterodimer partner in the liver tissue samples of the T2DM rats. In conclusion, FXR agonist treatment induces beneficial effects on metabolism in the rat T2DM model. In conclusion, the present study indicated that the FXR agonist may be useful for the treatment of T2DM and hypertriglyceridemia.

[Diagnosis and treatment of penetrating injury to the left ventricle].

OBJECTIVE: To review our experiences with diagnosis and treatment of 6 cases of penetrating injury to the left ventricle. METHODS: Six patients were admitted to the emergency department 0.5 to 3 h after the injury, all with shock and 3 with obvious pericardiac tamponade. All the patients received immediate thoracotomy for repairing the ruptured left ventricle, sub-pericardial window and pericardiocentesis, with also blood autotransfusion. RESULTS: All patients survived the operations. One patient required reexploration because of hemorrhage in the chest and two presented ST-segment changes in postoperative ECG, and one had nonspecific intraventricular conduction delay with T-wave inversion. CONCLUSIONS: Penetrating injury to the left ventricle is manifested by low blood pressure and signs of pericardial tamponade. Immediate thoracotomy to relieve the tamponade and effective hemostasis can be critical for management of such patients.